Chronic migraine (CM), defined by headache occurring at least 15 days per month and of which at least 8 are of the migraine type, is a major cause of morbidity. Management is aimed at both abortive and preventive therapy with the latter being of paramount importance given the impact on quality of life. Clinical evidence supports the use of botulinum toxin A and, more recently, anti-calcitonin gene related peptide (anti-CGRP) antibodies for refractory CMs. Galcanezumab, an anti-CGRP monoclonal antibody that prevents CGRP from binding to its receptors, is approved for chronic migraine prophylaxis. Data on combined treatment approaches for CMs, however, are limited.